Provider Demographics
NPI:1881043941
Name:WHITE, ROBERT (DPT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1265 WAYNE AVE STE 308
Mailing Address - Street 2:119 PROFESSIONAL BUILDING
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3501
Mailing Address - Country:US
Mailing Address - Phone:724-801-8095
Mailing Address - Fax:724-801-8147
Practice Address - Street 1:1300 N CHARLOTTE ST
Practice Address - Street 2:SUITE 14A
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-2351
Practice Address - Country:US
Practice Address - Phone:484-752-4372
Practice Address - Fax:484-752-4376
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT025277225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist